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A Child Health Assessment, recorded on a KDHE Form or other acceptable Forms mentioned below, is required for all children including children of the provider or staff in Family Child Care Homes, Child Care Centers, and Preschools.
PHYSICAL EXAMINATION. Note any unusual findings: Does this child have any health condition that would be hazardous either to the child or to other children in a group setting as a result of participation in normal activities (including sports)?
CHILD MEDICAL EXAMINATION REPORT (INFANT/TODDLER/PRE-SCHOOL) Based on my assessment of this child’s medical history, current state of health and my physical examination of the child on ____ / ____ / ____, this child can participate in a child care program. This child has no special care needs unless specified below.
Call ChildLine. 1-877-371-5422. You can now submit your your Child Abuse History Clearance request online. The Pennsylvania Department of Human Services (DHS), which is in part comprised of the Office of Children, Youth, and Families (OCYF) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color ...
To apply for child care licensing, complete and return the application and forms for your program type: Child Care Center, Preschool, and Head Start. Family Child Care Homes. School Age Program. School Age Drop-In Program. Day Care Resource and Referral Agency.
CH205 Health Exam 5 08 Rev. CHILD & ADOLESCENT HEALTH EXAMINATION FORM Please. Print Clearly. NYC DEPARTMENT OF HEALTH & MENTAL HYGIENE — DEPARTMENT OF EDUCATION Press Hard. STUDENT ID NUMBER OSIS. TO BE COMPLETED BY PARENT OR GUARDIAN. Child’s Last Name First Name Middle Name.
Additional information that will assist the child care program in providing appropriate child care for the above named child (special health care and developmental considerations) accompanies this form.
Infant, Toddler, Preschool Age ± Child Health Exam Form. In the event of an emergency, the child care provider is authorized to obtain EMERGENCY MEDICAL or DENTAL CARE even if the child care center is unable to immediately make contact with the parent/guardian.
Learn the importance of physical exams for daycare. Download a free Daycare Physical Form to document a child's health records.
MEDICAL EXAMINATION REPORT (INFANT/TODDLER & PRESCHOOL-AGE CHILD) I. IDENTIFYING INFORMATION. PATIENT’S NAME. BIRTHDATE. II. CURRENT STATE OF HEALTH. I HAVE EXAMINED THE ABOVE-NAMED CHILD AND VERIFY THAT THIS CHILD'S MEDICAL HISTORY AND CURRENT STATE OF HEALTH.